食管癌根治术后乳糜胸的诊断与治疗

目的探讨食管癌手术后乳糜胸的诊断与治疗。方法回顾性研究2000年1月—2009年6月504例食管癌外科手术患者的临床资料,术后并发乳糜胸6例,行保守治疗或再次开胸手术结扎胸导管。结果非手术治疗治愈l例,手术治疗治愈5例,均痊愈出院。结论食管癌术后乳糜胸诊断应结合临床症状、实验室检查及胸水量综合考虑。一旦确诊先行保守治疗,若每日引流量在1000m l以上,且每日无减少的趋势,须尽早手术。

Diagnosis and Treatment of Chylothorax after Operation for Esophageal Cancer

Objective To investigate the diagnosis and treatment of postoperative chylothorax after the operation for esophageal cancer.Methods Totally 504 patients with esophageal cancer underwent resection from January 2000 to June 2009.Postoperative chylothorax was found in 6 cases.Conservative therapy was used at first.If obvious curative effect failed to be achieved,treatment was switched over to operation.And ligation of thoracic duct was performed directly on the patients with drained thoracic fluid more than 1 000 ml per day.Results Among the 6 cases of postoperative chylothorax,1 was cured by conservative therapy,the others were transferred to surgical treatment and cured.ConclusionThe diagnosis of chylothorax after esophageal cancer should be generally considered by clinical symptoms,laboratory examination and hydrothorax.Once confirmed,conservative therapy must be used firstly.If the drained hydrothorax is more than 1 000 ml per day with non-decreasing trend,operation should be performed.